Cost-Effectiveness of High- and Low-Osmolality Contrast Media in Patients with High Risk of Contrast Induced Nephropathy

2009 ◽  
Author(s):  
Oscar Gamboa ◽  
Liliana Chicaíza ◽  
Mario García Molina
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Contrast Media ◽  
Contrast Induced Nephropathy

scholarly journals Radiologic Contrast Media Desensitization for Delayed Cardiac Catheterization

2019 ◽  
Vol 10 ◽  
pp. 215265671989284 ◽  
Author(s):  
Neha Sanan ◽  
Marija Rowane ◽  
Robert Hostoffer
Keyword(s):  
High Risk ◽  
Contrast Media ◽  
Cardiac Catheterization ◽  
Contrast Material ◽  
Preventative Measure ◽  
Contrast Induced Nephropathy ◽  
Radiographic Contrast ◽  
Radiographic Contrast Material ◽  
Medical Emergencies ◽  
Anaphylactoid Reactions

This protocol for rapid desensitization to intravenous radiographic contrast material (RCM) improves the strategy first reported by Uppal et al. Desensitization is a validated preventative measure for medical emergencies, such as cardiac catheterization, when patients present with histories of anaphylactoid reactions to the allergen of concern. The patient required another catheterization that was modified to repeat the final dosage of 320 mg/mL of Visipaque®, accommodating cardiac catheterization postponement, contrary to readministration of doses 4 (0.625 mg/mL) and 8 (10 mg/mL) as reported in Uppal et al. Our risk score calculations suggested that the patient was at low risk of contrast-induced nephropathy (CIN) that did not necessitate reduced dosage. No complications were reported following catheterization. We propose repetition of the final RCM dosage as a more effective and efficient desensitization strategy, as long as the scoring system does not indicate high risk for CIN.

Cost-effectiveness of iodixanol in patients at high risk of contrast-induced nephropathy

2005 ◽  
Vol 149 (2) ◽  
pp. 298-303 ◽  
Author(s):  
Peter Aspelin ◽  
Pierre Aubry ◽  
Sven-Göran Fransson ◽  
Ruth Strasser ◽  
Roland Willenbrock ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
High Risk ◽  
Contrast Induced Nephropathy

scholarly journals Vitamin C in the Prevention of Contrast-induced Nephropathy among High-risk Patients Undergoing Coronary Angiogram: A Meta-analysis

2021 ◽  
pp. 38-45
Author(s):  
Rainnier Y. Ong ◽  
Lou Andrew Palanca ◽  
Leana Agustin
Keyword(s):  
High Risk ◽  
Vitamin C ◽  
Contrast Media ◽  
Meta Analysis ◽  
High Volume ◽  
P Value ◽  
Coronary Angiogram ◽  
Contrast Induced Nephropathy ◽  
High Risk Patients ◽  
Risk Patients

Background: Contrast-Induced nephropathy (CIN) is one of the leading causes of acute kidney injury. The most common procedures associated with CIN are coronary angiography and contrast enhanced computed tomography (CT) [1].  The most common definition in use is an increase in serum creatinine (SCr) of >25% of the baseline values occurring following the intravascular administration of contrast media without an alternative explanation [2]. Generation of reactive oxygen species is thought to play a role in the pathogenesis of CIN, hence researches have been conducted into the potential role of antioxidants in the prevention of contrast-induced nephropathy [3]. Vitamin C, a potent antioxidant in humans has the ability to oxidize free radicals, and has been studied in different trials to measure its ability to prevent CIN among patients undergoing coronary angiogram. Objective: To determine if vitamin C prevents CIN among High-risk patients (Creatinine Clearance <60 ml/min/m2, Diabetics, and on administration of high-volume contrast media). Methodology: All studies, limited to randomized clinical trials were sought for this analysis through PubMed, the Cochrane Library, ClinicalTrials.gov. Database was searched using the terms “vitamin C”, “Prevention”, “acute kidney injury” and “contrast-induced nephropathy”. Adult patients (40-90 years old) with Creatinine Clearance of <60 ml/min/m2 or baseline creatinine >1.2 mg/dl, Diabetes Mellitus Type II, and were administered with high-volume contrast media (>100ml) undergoing coronary angiogram were included in the study. Exclusion Criteria were patients with normal baseline renal function, without risk factors for CIN, with EGFR < 30 ml/min/m2, with regular intake of Vitamin C and were on dialysis. Statistical data were obtained using Review Manager (RevMan) Version 5.3 freeware program.  P Value was obtained using the Cochran–Mantel–Haenszel test (CMH).  Included patients were given Vitamin C at doses of 1 gram to 3 grams, taken orally or administered intravenously pre-and post coronary angiogram. Results:  Seven hundred and one (N=701) patients were included in this meta-analysis.  CIN occurred in 3.5% of patients (N=25) in the ascorbic acid group and in 6% of patients (N= 42) in the placebo group (p value of 0.03). Conclusion: Vitamin C given at doses 1 gram to 3 grams in combination with hydration prior to coronary angiogram may have a significant effect in the prevention of CIN in high-risk patients.

scholarly journals Cost-effectiveness of Baloxavir Marboxil compared with Laninamivir for the treatment of influenza in patients at high risk for complications in Japan

2021 ◽  
pp. 1-1
Author(s):  
Mariia Dronova ◽  
Hidetoshi Ikeoka ◽  
Naoya Itsumura ◽  
Nobuo Hirotsu ◽  
Amir Ansaripour ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
High Risk
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